Dew M.A.,Psychology |
DiMartini A.,University of Pittsburgh |
DiMartini A.,Western Psychiatric Institute and Clinic
Current Opinion in Psychiatry | Year: 2015
Purpose of review. Psychiatrists and other mental health professionals typically assist with evaluating and treating psychiatric and behavioral issues in transplant candidates, recipients, and living organ donors. In this review recent findings on specific psychiatric issues in adult solid organ transplant candidates and recipients, as well as living donors are discussed as well as their relevance to clinical practice. Recent findings. Patients with complex mental health and addiction histories can have outcomes similar to patients without these disorders but may require specialized pretransplant preparation or posttransplant interventions to optimize their outcomes. Specific attention to the preparation and wellbeing of living donors is needed. Summary. As transplant programmes increasingly consider patients with complex mental health histories, psychiatrists, and mental health professionals evaluating and treating these patients need to consider plans for early identification and treatment. Psychiatric care provided across the preoperative to postoperative periods will best address the longitudinal care needs of patients with mental health disorders. Abstinence from substances and complete adherence to medical directives provides the best chance for optimal outcomes. Treatment of depression may improve transplant outcomes. Research is needed to identify effective interventions and the best strategies to engage patients to improve adherence. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
Dolgoff-Kaspar R.,Psychology |
Dolgoff-Kaspar R.,City University of New York |
Ettinger A.B.,Neurological Surgery PC |
Golub S.A.,City University of New York |
And 3 more authors.
Epilepsia | Year: 2011
This study investigated hyperreligiosity in persons with partial epilepsy by exploring a relationship between aura symptoms and spirituality. It was reasoned that patients with high frequencies of auras that are suggestive of metaphysical phenomena, termed numinous-like auras, would report increased spirituality of an unconventional form, both during their seizures and generally. Numinous-like auras included: dreaminess/feeling of detachment, autoscopy, derealization, depersonalization, time speed alterations, bodily distortions, and pleasure. A high-frequency aura group, low-frequency aura group, and nonseizure reference group were compared on the Expressions of Spirituality-Revised. The High group had significantly greater Experiential/Phenomenological Dimension and Paranormal Beliefs factor scores than the Low group, and significantly greater Experiential/Phenomenological Dimension factor scores than the reference group. There were no differences between the Low group and the reference group. In addition, there were no differences among the three groups on traditional measures of religiosity. The results provide preliminary evidence that epilepsy patients with frequent numinous-like auras have greater ictal and interictal spirituality of an experiential, personalized, and atypical form, which may be distinct from traditional, culturally based religiosity. This form of spirituality may be better described by the term cosmic spirituality than hyperreligiosity. It is speculated that this spirituality is due to an overactivation and subsequent potentiation of the limbic system, with frequent numinous-like auras indicating sufficient activation for this process to occur. It is likely that numinous-like experiences foster cosmic spirituality in a number of circumstances, including seizures, psychosis, near-death experiences, psychedelic drug use, high-elevation exposure, and also normal conditions. Wiley Periodicals, Inc. © 2011 International League Against Epilepsy.
PubMed | Psychology., Sociology., University of Alabama at Birmingham and Clinical and Diagnostic science and.
Type: Journal Article | Journal: The Journal of nutrition | Year: 2016
Body mass index (BMI, in kg/m(2)) is positively associated with plasma glucose in late pregnancy and with risk of adverse obstetric outcomes. Much of the existing research uses single-clinic measures of plasma glucose, which may not accurately reflect circulating glucose under free-living conditions. Furthermore, little is known about circulating glucose concentrations of African American women, who tend to have poorer diet quality and a greater risk of obstetric complications.The objective of the study was to test the hypothesis that the positive association of BMI in early pregnancy with third-trimester circulating glucose concentrations measured under free-living conditions among African American women would be at least partially attributable to lower -cell insulin secretion relative to insulin sensitivity [i.e., lower disposition index (DI)].Using a prospective, observational design, 40 pregnant African American women (mean SD age: 23.1 4.0 y; mean SD BMI: 28.4 7.5) wore continuous glucose monitors and accelerometers for 3 d at 32-35 wk of gestation and concurrently maintained a food diary to report their self-selected meals. The DI was derived from a 75-g oral glucose tolerance test. Linear regression modeling was used to calculate the association of BMI with the 24-h glucose (GLUC24h) and 2-h (GLUC2hPP) postprandial glucose areas under the curve and with the percentage of time the glucose concentrations were >120 mg/dL.The positive associations between BMI and GLUC24h (standardized = 0.36, P = 0.03) and the percentage of time glucose concentrations were >120 mg/dL (standardized = 0.40, P = 0.02) were independent of total carbohydrate intake and physical activity and were attenuated when DI was added to the model. The positive association of BMI with GLUC2hPP was attenuated when DI was added to the model, and DI itself was independently associated with GLUC2hPP after self-selected breakfast and dinner (standardized = -0.33 and -0.42, respectively; P = 0.01).The association of BMI with high circulating glucose in free-living pregnant African American women is at least partially attributable to lower -cell responsiveness.
Stenzel N.,University of Marburg |
Krumm S.,University of Munster |
Hartwich-Tersek J.,Psychology |
Beisel S.,Salus Klinik Lindow |
Rief W.,University of Marburg
Clinical Psychology and Psychotherapy | Year: 2013
Recent research on psychotherapy has focused on the development and evaluation of disorder-specific treatments. Even though much progress has been made, treatments have not yet reached an ideal level of effectiveness. One reason for this could be the systematic overlap and high comorbidity between mental disorders. Consequently, a new trend has been the examination of transdiagnostic factors in order to conceptualize psychopathology and develop treatment tools. One approach is to strengthen skills (e.g., emotion regulation) that are relevant in different mental disorders. The unique feature of this study is the simultaneous examination of several skills and their relation to psychopathology. Therefore, the current study investigated the skill levels of different groups of inpatients (tinnitus, tinnitus/unipolar mood disorder and anxiety/unipolar mood disorder) and normal controls (n=124). Participants were evaluated with the 'operationalized assessment of skills interview'. This interview allows the simultaneous assessment of seven skills (problem solving, social competence, stress management, emotion regulation, relaxation ability, self-efficacy and self-esteem) that are relevant for treatment planning. The results confirm negative correlations between skills and the number of comorbid diagnoses. Multivariate analyses identified significant differences in skill levels between clinical sample and normal controls. Furthermore, within the clinical sample, there were significant differences in skill levels and skill profiles between the different clinical subsamples. To conclude, the improvement of skills that can support recovery from mental disorders is especially relevant for patients with multiple diagnoses. The authors suggest assessing the different skills prior to treatment and considering the skill profiles when planning interventions. © 2012 John Wiley & Sons, Ltd.
Grey I.,Trinity College Dublin |
Al-Saihati B.A.,Senior Cycle |
Al-Haddad M.,Arabian Gulf University |
Journal of Intellectual Disability Research | Year: 2015
Background: Relatively little information is available regarding the use of psychiatric services by individuals with intellectual disability (ID) in Arab countries. The current study aimed to identify (1) the reasons for referral; (2) demographic characteristics of individuals referred; (3) previous contact with child psychiatric services; (4) psychiatric diagnoses; (5) level of ID; (6) nature of interventions; and (7) patterns of medication usage in individuals attending a specialist psychiatric service for individuals with an ID in the Kingdom of Bahrain. Method: Case file analysis was used. Files that recorded attendance at the specialist service within a specific calendar year were selected. A total of 537 files were available for review and 79 contained records indicating the individual had been seen within the year. Results: The primary referral reason to adult psychiatric services was the presence of behavioural disturbance. Pharmacological intervention was the dominant treatment choice and no individual was recommended for psychological/behavioural intervention. Psychiatric diagnosis was not recorded in over 90% of cases. Conclusion: Services in the Kingdom of Bahrain for individuals with ID rely exclusively on pharmacological approaches for the treatment of behavioural disorders. Implications for best practice guidelines are discussed. © 2013 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.
Ingersoll B.,Psychology |
Walton K.,Michigan State University |
Carlsen D.,New York Center for Discovery |
Hamlin T.,New York Center for Discovery
American Journal on Intellectual and Developmental Disabilities | Year: 2013
Individuals with autism have difficulty with social skills across the lifespan. Few social interventions have been examined for older individuals with autism who also have significant intellectual disabilities (ID). Previous research suggests that reciprocal imitation training (RIT) improves imitation and social engagement in young children with autism. This study used a multiple-baseline design to examine whether RIT could improve social behaviors in four adolescents with autism and significant ID. All adolescents improved their spontaneous imitation and two improved their joint engagement. In addition, two adolescents decreased their rate of self-stimulatory behaviors over the course of treatment. Overall, these results suggest that RIT may be effective at improving social interaction and decreasing self-stimulatory behavior in adolescents with autism and significant ID. © EAAIDD.
Alexander R.T.,PIC LD Services |
Green F.N.,Nursing |
O'Mahony B.,Psychology |
Gunaratna I.J.,PIC LD Services |
And 2 more authors.
Journal of Intellectual Disability Research | Year: 2010
Aim: To establish any differences between patients with and without a diagnosis of personality disorders, being treated in a secure inpatient service for offenders with intellectual disability (ID) in the UK. Method: A cohort study involving a selected population of people with ID and offending behaviours. Results: The study included a total of 138 patients, treated over a 6 year period - 77 with a dissocial or emotionally unstable personality disorder and 61 without. Women were more likely to be in the personality disorder group. Both groups had high prevalence of abuse with no significant differences. Depressive disorders and substance abuse were more common in the personality disorder group, while epilepsy and autistic spectrum disorders were more common in the non-personality disorder group. Rather than differences, what was more striking was the rate and range of these comorbidities across both groups. Although past histories of violence and institutional aggression were no different, compulsory detention under criminal sections and restriction orders were more common in the personality disorder group. There were no differences in treatment outcomes. Conclusions: Although about half of patients detained in secure units for offenders with ID have a personality disorder, there were more similarities than differences between this group and the rest. While good treatment outcomes supported the case for specialised secure treatment units for people with ID, the case for establishing a more specialised ID-personality disorder unit was less convincing. There is also a need to explore whether there are alternative diagnostic models that can delineate better the group with personality difficulties in this population. © 2010 The Authors. Journal Compilation © 2010 Blackwell Publishing Ltd.
Universal Access in the Information Society | Year: 2010
Using social psychology, this study discursively explores barriers limiting the online experiences of people with disabilities. Twenty-one people in New Zealand with physical and sensory disabilities volunteered to participate in an online interview. Data demonstrated a disabling differentials repertoire (pattern), comprising four linguistic resources: negative reactions (when disability was disclosed), exclusion, gatekeeping, and disability costs. In addition to the technology alone, human values embedded in the construction of online technology, and participants' cultural competency, as well as stereotyped attitudes and economic factors prevalent offline, define and restrain people with disabilities' online experience. The social identity model of deindividuation is discussed. © 2009 Springer-Verlag.
Human vaccines & immunotherapeutics | Year: 2014
INTRODUCTION: To describe adolescents' perspectives regarding the use of school-located immunization programs (SLIP) for influenza vaccination. More importantly, adolescents were asked what factors would make them more or less likely to use a SLIP offering influenza vaccine.RESULTS: Participants were generally found to be knowledgeable about influenza and to have positive attitudes toward receiving the vaccine via SLIP. Students were more willing to participate in a SLIP if it were low cost or free, less time-consuming than going to a doctor, and if they felt they could trust vaccinators. Overall, high school and middle school students ranked the benefits of SLIP similarly to each other.METHODS: Focus groups using nominal group method were conducted with middle and high school students in a large, urban school district. Responses were recorded by each school, and then, responses were ranked across all participating schools for each question.CONCLUSIONS: A wide range of issues are important to middle and high school students when considering participation in SLIPs including convenience, public health benefits, trust in the program, program safety, and sanitary issues. Further research will be needed regarding the generalizability of these findings to larger populations of students.
PubMed | Psychology
Type: | Journal: Health & social care in the community | Year: 2016
Primary care psychology services (PCPS) represent an important resource in meeting the various health needs of our communities. This study evaluated the PCPS in a two-county area within the Republic of Ireland. The objectives were to (i) examine the viewpoints of the service for both psychologists and stakeholders (healthcare professionals only) and (ii) examine the enactment of the stepped care model of service provision. Separate surveys were sent to primary care psychologists (n=8), general practitioners (GPs; n=69) and other stakeholders in the two counties. GPs and stakeholders were required to rate the current PCPS. The GP survey specifically examined referrals to the PCPS and service configuration, while the stakeholder survey also requested suggestions for future service provision. Psychologists were required to provide information regarding their workload, time spent on certain tasks and productivity ideas. Referral numbers, waiting lists and waiting times were also obtained. All 8 psychologists, 23 GPs (33% response rate) and 37 stakeholders (unknown response rate) responded. GPs and stakeholders reported access to the PCPS as a primary concern, with waiting times of up to 80weeks in some areas. Service provision to children and adults was uneven between counties. A stepped care model of service provision was not observed. Access can be improved by further implementation of a stepped care service, developing a high-throughput service for adults (based on a stepped care model), and employing a single waiting list for each county to ensure equal access.